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In an unexpected move, the BMA’s chairman Jim Johnson has resigned after a storm of protest at a letter he wrote to The Times supporting the government’s reforms of medical education — and stating that continuing to use the flawed MTAS system for appointing round 1 candidates was the ‘best available solution’.

His letter, written with Carol Black, chairman of the Academy of Medical Royal Colleges, caused a furore among BMA members over the weekend and led to Mr Johnson’s decision to stand down on Sunday (20 May).

A number of comments about whether it was right he continue as chairman were posted by BMA council members on the association’s website, he told the BMJ. It’s understood he was placed in a position where he had little choice but to resign.

Many junior doctors had been furious that the BMA representatives on the MTAS review group had gone along with the proposal to continue with the existing interviews, despite the fact they were based on the flawed MTAS computer system. At one point it looked as if Jo Hilborne, chair of the Junior Doctors Committee, would lose a vote of no confidence, but she managed to weather that storm.

Mr Johnson claims his letter was merely reiterating existing BMA policy. What seems to have most annoyed BMA members was the paragraph in which he and Carol Black said they “restated their support for the Chief Medical Officer and his role in improving junior doctors’ training”.

“The Chief Medical Officer seems to be a bit of a hate figure within the BMA at the moment,” Mr Johnson said. “I think it is my job to support any member that is being got at and isn’t in a position to support himself,” he added referring to the fact the Chief Medical Officer, a BMA member and architect of the medical education reforms, was under attack from Remedy UK— along with health secretary Patricia Hewitt.

He defended the comments he made on MTAS, arguing that what he wrote was in line with the BMA’s policy:

“MTAS may not be a very good system but we’ve got to be pragmatic,” he said. The BMA had accepted the current round of interviews should go ahead, albeit on a flawed application system, because: “Doctors have to be in training posts by August.”

The suggestion by Remedy UK, up until the eve of their court case, that the interviews carried out so far should be scrapped, was not accepted by the BMA he said. “The rather flawed system has got to go ahead,” he said.

“I think modernising medical careers has a lot of faults,” said Mr Johnson. “But in the past SHOs had no hope of promotion and were just going from job to job.”

But given the sensitivity of the MTAS issue — with many junior doctors threatening to leave the BMA over the line it had taken — Mr Johnson’s letter was bound to offend many association members.

He told the BMJ that he did not consult the BMA before writing to The Times. “The BMA policy is that we support MMC,” he said. “We can’t have a policy we are ashamed of. I don’t have to consult every time I write a letter.”

Mr Johnson said it was “completely untrue” that he wasn’t angry about what had happened over MTAS. “But I don’t regret coming to the aid of a colleague.”

Mr Johnson was probably going to stand down from the BMA next month in any case, after being at the helm for four years. “I was feeling for a long time that four years was enough,” he said. “But I wouldn’t have chosen to end it in this way.

“It’s got to the stage where it is actually damaging the association. There have been a few resignations and if your own council members are being critical of you, that is a situation where I am no longer helping.”

He defended his decision to support the CMO, although many members feel this put the BMA too close to government. “The BMA is always seen as a bit of the establishment. There will always be members who say the BMA isn’t doing enough.

This is just to let you know that I feel that the BMA as an organisation has betrayed the trust of many of its members ( especially the junior ones ), and in my opinion behaved in the whole MMC/MTAS crisis in an absolutely cowardly, selfserving and unfortunately some would say traitorous fashion. The conduct of our senior medics as a whole in the various colleges and representative bodies also leaves very much to be desired.

The BMA appearing in court against the junior doctors remedy judicial case was unwarranted and unfortunate, and then the letter from the BMA president to The Times certainly showed many of us how far the BMA has veered from representing its members interests.

All I can say is an absolute good riddance to James Johnson, his totally misguided attempts to justify the unjustifiable, and his attempts to try to keep a hopelessly flawed system afloat. Where are the BMA’s ideals ? Lost in political pragmatism and greasy pole climbing I suppose.

Hopefully as an organisation the BMA will learn some lessons from this utterly unedifying experience. It is the only real union we have at the moment, and we have to support it, but it shouldn’t deceive itself that that situation will necessarily remain so if real change in it’s outlook is not made soon. The times have changed, and the old heirarchical medical system of seniors telling juniors what is good for them ( and they either like it or lump it ) is fast fading away. If we want to remain a reasonably united profession then we must grant our junior colleagues an equal voice in their future, and not the current condescending voice of pusillanimous pragmatism.

Thank you, and kind regards.

Tunde Odutoye

John J Turner

Some uncomfortable but vital lessons must be learned from the MTAS disaster to avoid more of the same.
The BMA and the Academy of Royal Colleges have looked weak and ineffectual having entered into ‘partnership’ roles with the DoH.
The early agreements over generalities are rather like motherhood and apple pie and easy to sign up to. The trap is sprung and the incompetent poorly developed operational details are released deliberately late in the process. The government ploy is then to insist that the major players were all on board.
A full professional analysis and scrutiny of detailed proposals must be gone through well before schemes such as this and their are many others become a fait accompli.
This pseudo collaberation is actually a major system failure between the Department of Health and the profession.
The Chief Medical Officer as the government appointee and a major architect of the process surely needs no sympathy from the chairman of the BMA.